Indications And Dose
Asthma | Other conditions associated with reversible airways obstruction ▶BY MOUTH ▶Adult: Initially 2.5 mg 3 times a day for 1–2 weeks, then increased to up to 5 mg 3 times a day, use by inhalation preferred over by mouth ▶BY SUBCUTANEOUS INJECTION, OR BY SLOW INTRAVENOUS INJECTION ▶Adult: 250–500 micrograms up to 4 times a day, reserve intravenous beta2 agonists for those in whom inhaled therapy cannot be used reliably or there is no current effect ▶BY CONTINUOUS INTRAVENOUS INFUSION ▶Adult: 90–300 micrograms/hour for 8-10 hours, to be administered as a solution containing 3–5 micrograms/mL, high doses require close monitoring, reserve intravenous beta2 agonists for those in whom inhaled therapy cannot be used reliably or there is no current effect ▶BY INHALATION OF POWDER ▶Adult: 500 micrograms up to 4 times a day, for persistent symptoms ▶BY INHALATION OF NEBULISED SOLUTION ▶Adult: 5–10 mg 2–4 times a day, additional doses may be necessary in severe acute asthma Acute asthma ▶BY SUBCUTANEOUS INJECTION, OR BY SLOW INTRAVENOUS INJECTION ▶Child 2–14 years: 10 micrograms/kg up to 4 times a day (max. per dose 300 micrograms), reserve intravenous Respiratory system beta2 agonists for those in whom inhaled therapy cannot be used reliably or there is no current effect ▶Child 15–17 years: 250–500 micrograms up to 4 times a day, reserve intravenous beta2 agonists for those in whom inhaled therapy cannot be used reliably or there is no current effect ▶BY CONTINUOUS INTRAVENOUS INFUSION ▶Child: Loading dose 2–4 micrograms/kg, then 1–10 micrograms/kg/hour, dose to be adjusted according to response and heart rate, close monitoring is required for doses above 10 micrograms/kg/hour, reserve intravenous beta2 agonists for those in whom inhaled therapy cannot be used reliably or there is no current effect Moderate, severe, or life-threatening acute asthma ▶BY INHALATION OF NEBULISED SOLUTION ▶Child 1 month–4 years: 5 mg, repeat every 20–30 minutes or when required, give via oxygen- driven nebuliser if available ▶Child 5–11 years: 5–10 mg, repeat every 20–30 minutes or when required, give via oxygen-driven nebuliser if available ▶Child 12–17 years: 10 mg, repeat every 20–30 minutes or when required, give via oxygen-driven nebuliser if available ▶Adult: 10 mg, repeat every 20–30 minutes or when required, give via oxygen-driven nebuliser if available Exacerbation of reversible airways obstruction (including nocturnal asthma) | Prevention of exercise-induced bronchospasm ▶BY INHALATION OF POWDER ▶Child 5–17 years: 500 micrograms up to 4 times a day, for occasional use only ▶BY MOUTH ▶Child 1 month–6 years: 75 micrograms/kg 3 times a day (max. per dose 2.5 mg), administration by mouth is not recommended ▶Child 7–14 years: 2.5 mg 2–3 times a day, administration by mouth is not recommended ▶Child 15–17 years: Initially 2.5 mg 3 times a day, then increased if necessary to 5 mg 3 times a day, administration by mouth is not recommended Uncomplicated premature labour (between 22 and 37 weeks of gestation) (specialist supervision in hospital) ▶BY INTRAVENOUS INFUSION ▶Adult: Initially 5 micrograms/minute for 20 minutes, then increased in steps of 2.5 micrograms/minute every 20 minutes until contractions have ceased (more than 10 micrograms/minute should seldom be given— 20 micrograms/minute should not be exceeded), continue for 1 hour, then reduced in steps of 2.5 micrograms/minute every 20 minutes to lowest dose that maintains suppression (maximum total duration 48 hours)
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